Detailed A/R analysis
We bucket every claim by age, payer, and denial reason. Patterns surface. Priorities get clear.
Stuck claims. Aged receivables. Denials nobody appealed. We dig into the pile, work the claims, and bring the money home. Up to 81% recovery rate.
Aged claims need a different playbook than fresh claims. We bring it.
We bucket every claim by age, payer, and denial reason. Patterns surface. Priorities get clear.
Weekly payer calls. Web portal logins. Letter campaigns. Whatever it takes to get a determination.
Every denial reviewed, categorized, and worked. Coding errors fixed. Documentation re-submitted.
Formal appeals drafted, evidence attached, deadlines tracked. We push payers when they push back.
Each payer is different. We tailor the workflow to their adjudication patterns and historical responses.
Why did the claim get stuck in the first place? We feed insights upstream so it doesn't happen again.
Practical answers about working aged A/R the right way.
MGMA benchmarks vary by specialty, but typical healthy ranges: primary care 28 to 35 days, cardiology 32 to 40, orthopedics 35 to 45, mental and behavioral health 25 to 35, dental 30 to 40. If your A/R sits above the high end of your range, money is leaking. If it's in the bottom quartile, you're probably getting paid faster than peers.
Yes. Aged A/R cleanup is a common engagement starter. We pull your aging report, triage what's still appealable under each payer's timely filing window, work the high-dollar claims first, and document outcome on every one. Recovery is paid only if we collect; no charge if a claim genuinely can't be recovered.
Aggressive. First-level appeals get filed with the medical record, applicable LCD/NCD references, and clinical justification. Second-level appeals escalate to a payer medical director. State-level external review and IDR (No Surprises Act) come into play for out-of-network disputes. We don't write off appealable claims because they're tedious to work.
Around 81% on appealable denials, blended across payer mix. Recovery on aged claims (90 to 365 days) averages 30 to 60% of net billable depending on age and original denial reason. Anyone quoting a single magic number across all claims is selling, not measuring.
Sometimes. Most payers have timely filing limits between 90 days and 365 days. Once past that window, only specific exceptions (provider error, payer error, retroactive eligibility, COB confusion) reopen the claim. We screen for those exceptions and pursue what's genuinely recoverable. Honest answer: claims aged past timely filing with no exception are usually a write-off.
Yes. Recovering one claim is good; preventing 100 future denials of the same type is better. Monthly we surface denial trend reports: top CARC/RARC reasons by payer, which providers see them most, and what upstream change (registration, eligibility, coding, documentation) closes the loop.
Always. Your A/R is your A/R. If we ever part ways, you get a clean handoff: full claim list with status, denial documentation, work notes, and any pending appeals. No data hostage situations, no exit fees on collected balances.
30-minute free billing audit. We'll surface the leaks (undercoding, denials never appealed, eligibility errors) and quantify the dollars you can recover this quarter.
